title: Immunogenicity of anti-TNFα therapy in psoriasis: a clinical issue?
abstract: BACKGROUND
  Immunogenicity of antitumor necrosis factor-alpha (TNFα) agents has been proven to play a significant role in the variability of clinical responses among patients with chronic inflammatory diseases. However, its clinical impact on the outcome of patients with psoriasis and psoriatic arthritis receiving anti-TNFα treatment is not yet fully clear. Despite the high rates of efficacy of anti-TNFα agents in psoriasis, a substantial proportion of patients remain who experience a primary or secondary failure or significant side effects, which are potentially ascribable to immunogenicity.
  
  
  METHODS
  Topics include immunologic response elicited by anti-TNFα agents, the impact of immunogenicity on treatment response to anti-TNFα and the role played by immunogenicity in the lack of efficacy of anti-TNFα agents (infliximab, adalimumab and etanercept) in psoriasis.
  
  
  CONCLUSIONS
  Based on data available in the literature and the clinical experience of the authors, this article suggests the optimal approach to drug monitoring and antidrug antibody assay and the most effective use of biologic immunotherapies in this setting. Immunogenicity should be taken into account in the adoption of therapeutic choices in psoriatic patients, such as anti-TNFα agent intensification, or switching to another anti-TNFα agent or a drug with a different mechanism of action.
authors.affiliation: Catholic University of the Sacred Heart, Department of Dermatology , L.go A.Gemelli 8; 00168 Rome , Italy +390630154227 ; +39063016293 ; clara.desimone1@gmail.com.
authors.forename: Clara
authors.initials: C
authors.lastname: De Simone
authors.forename: Paolo
authors.initials: P
authors.lastname: Amerio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Amoruso
authors.forename: Federico
authors.initials: F
authors.lastname: Bardazzi
authors.forename: Anna
authors.initials: A
authors.lastname: Campanati
authors.forename: Andrea
authors.initials: A
authors.lastname: Conti
authors.forename: Paolo
authors.initials: P
authors.lastname: Gisondi
authors.forename: Giulio
authors.initials: G
authors.lastname: Gualdi
authors.forename: Claudio
authors.initials: C
authors.lastname: Guarneri
authors.forename: Luca
authors.initials: L
authors.lastname: Leoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Loconsole
authors.forename: Annamaria
authors.initials: A
authors.lastname: Mazzotta
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Musumeci
authors.forename: Stefano
authors.initials: S
authors.lastname: Piaserico
authors.forename: Concetta
authors.initials: C
authors.lastname: Potenza
authors.forename: Francesca
authors.initials: F
authors.lastname: Prestinari
mesh_terms: D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000917:Antibody Formation / Q000502:physiology*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000276:immunology; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept